Study of cerebral hemodynamics in children with small anomalies of the heart development

Abstract

Annotation. Diseases of the cardiovascular system occupy a leading place in the structure of non-infectious pathology. In the literature, small abnormalities of the development of the heart are described as abnormally located trabeculae or additional chords in the left ventricle of the heart or mitral valve prolapse. At present, the problem of cerebral hemodynamic disorders in children with them is insufficiently studied in medical sources. The aim of our study was to analyze cerebral hemodynamics using ultrasound dopplerography of cerebral vessels in children with abnormally attached chords (AAC) and mitral valve prolapse (MVP). We examined 64 children with AAC and 106 patients with MVP (among whom there were 90 with MVP I degree and 16 with MVP II degree) aged from 13 to 17 years, who formed the main group. The results were compared with the data of the control group, which included 23 almost healthy children also aged 13–17 years. All children underwent ultrasound dopplerography of extra- and intracranial vessels and veins of the brain. Evaluated the average values in the form of M±m. The values of the differences between the indicators of the two samples were evaluated by Student’s parametric criterion (t) using a special program such as Microsoft Excel. In children with MVP I deg. we found a pronounced violation of blood flow in a. vertebralis on both sides with diagnostically significant (р<0,05) decrease in the mean values of systolic and diastolic blood flow indexes. The elasticity of the vessels was high relative to the control group. In children with grade II MVP, a decrease of the blood flow was observed within a. vertebralis basin, which was accompanied by a significant (р<0,05) decrease of systolic and diastolic velocities on both sides in comparison with control group. An increase (р<0,05) in systolic-diastolic index (Sd) and circulatory resistance index (Ri) was noted in both sides, indicating a simultaneous increase in the tone and elasticity of these vessels. In patients with AAC there was a decrease in systolic and diastolic velocities in the a.vertebralis on both sides with increase of Sd relative to the control group. Thus, cerebral blood flow in children with AAC and MVP is generally satisfactory. There are changes in the elastic and tonic properties of blood vessels in these children. The results of the study will be useful to narrow specialists for timely and adequate rehabilitation of patients with MARS.